HomeMy WebLinkAboutB13-0137 REV1 TRANSMITTAL (GAS LINE) Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when submitting additional information for planning applications or building permits.
This form is also used for requesting a revision to building permits. A two hour minimum building review
fee of$110 will be charged upon reissuance of the permit.
Application/Permit#(s)information applies
to: Attention: ( )Revisions
Response to Correction Letter
attached copy of correction letter
13 0050 ( ) Deferred Submittal
Other
Project Street Address:
MAa1).35 t�vJcF1 �-
(Number) (Street) (Suite#)
Building/Complex Name:�to�`CH L°QED (�oN 'Description of Transmittal/List of Changes, Items Attached:
f ZEp(�iC'� �CIS`f hl� UNDE 2 G C'-cU/U�.
Applicant Information 11
S �ccPP( Y LINE. (APec>X �J
(architect,contractor,ownerlowner's re
p))�
{\UON 'P�UHZJAJG
Contact Name: ID
Address: Pfl
City State: Zip:
�163Z }
Contact Name: (use additional sheet if necessary)
c9-10 91D4 00g I
Contact Phone. / Building Permits:
Revised Valuations Labor&Materials
L�►ar�c7 a�o� t,t,fs�tb�rs Cow ( )
Contact E-Mail. i ADDITIONAL Vl i
;(DO NOT include original valuation)
12
I hereby acknowledge that I have read this application,filled out !Building: $ lb
in full the information required,completed an accurate plot plan,
and state that all the information as required is correct. I agree to Plumbing: $
comply with the information and plot plan,to comply with all Town
ordinances d state I s, and to build this structure according Electrical: $
to the to zonin subdivision codes, design review ap-
proved, n rnati ildin ndd Resideptial Codes and other Mechanical: $
ordina soft lCl th
X Total: $
Owner/Owner's Representati Sin (Required) -- -- -
Date Received:
For Office Use Only:
Fee Paid: $EP 0 3 2013
Received From:
Cash Check# (�,�){�F/►-
CC: Visa/MC Last 4 CC# exp.date: TOWN OF VAIL
Auth#